St. Kitts and Nevis' Chief Medical Officer, Dr. Patrick Martin

"St. Kitts and Nevis is part of the international campaign to restrict the entry of the Avian Influenza, also know as Bird Flu, to the human population," said Chief Medical Officer, Dr. Patrick Martin.

A National Strategic Plan consistent with Pan American Health Organisation 'World Health Organisation (PAHO/WHO) blueprint and accounting for local conditions is in place and operational procedures to govern the actions of community health and hospital personnel in the event of a local outbreak have been accomplished.

He told the Communications Unit in the Office of the Prime Minister that the Ministries of Health on both islands are engaged in planning and preparing.

"We have the conceptual framework of what we need to do. We know what we need to do.  We know why we are to do it, we even know when.  The issue is how many people are going to get sick and how much material - human resources and money will be necessary," he said on National Echo, a radio and television programme aired weekdays.

Dr. Martin pointed out that there are two ways for this virus to get to St.

Kitts and Nevis. "It is either via a migratory bird or via a migratory human.  The migratory bird patterns are North-South, from North America to South America," said Dr. Martin.

He said that he has been told by the Chief Veterinary Officer, Dr. (Tracey) Challenger,  that "our situation is minimal in terms of migratory birds, but still migratory birds do pass through our areas."

"In fact, we had a meeting yesterday and we discussed some step by step scenarios where we are likely to see dead migratory birds on the coasts. And so we went through some step by step scenarios, which we will roll out some more information of this to the general public through the media," said the Chief Medical Officer, who also disclosed that the Animal Health/Vet Services Unit at the Ministry of Agriculture already has some surveillance going on with respect to migratory birds, especially in the coastal areas.

He said that the other way for the Avian Flu Influenza to get to St. Kitts and Nevis is via migratory humans. "It takes us eight hours via jet from London-Gatwick, England and three to four hours from North America. So a sick person can be here within a very short period of time.  So the steps have to be put in place to monitor or screen persons getting on to a plane and persons coming off a plane," said the CMO, pointing out that St. Kitts and Nevis is party to two International Health Regulations. 

Dr. Martin said that Ministries of Health will soon put in place a Health Unit at each port of entry.

He said that was very important to define the terms because the media have been creating some confusion of the terms.

"We are speaking of an influenza virus that is now epidemic in the poultry population and there are reports that it is now spreading to the cat population, in Asia, Europe and parts of Africa."

"The other parts of Africa that have not reported for example, in the areas where there is war or communication breaks down and that is in the Avian population. Then you have the Human H5N1 or human bird flu; so far 177 cases of Human H5N1 have been reported to the World Health Organization, unfortunately 98 deaths have been reported, which means a case mortality rate of 55 percent," said the Chief Medical Officer.

"So where as we know of 177 human cases, basically in Southeast Asia, extending also to Iraq and Turkey, the number of  cases in the bird population exceeds tens of thousands.  It is very important to make that distinction," Dr. Martin pointed out.

He said further that for all intents and purposes, what the world is facing right now is an Avian issue and the human side is still fairly well contained and the world is in Pandemic Alert 3.

"There's a scoring system from one to six, where six means all hell has broken lose and a world wide pandemic has been declared.  We're at three, which means very little, the number of cases in human beings is very small.   When we get to a four, it means that things are ratcheting up in a particular locale. When we get to a five, the figures are spreading even further in a region; when we get to a six, we're talking about a world wide outbreak. 

"It is very important for us to separate the two. If you are a bird for all intents and purposes, if you are a bird, we already have a pandemic, but for the human side, no, explained the Chief Medical Officer.

Ask what is likely to happen if St. Kitts and Nevis is affected, the Chief Medical Officer said: "The worst case scenario calls for up to 35 percent of

 the population being affected and we are talking about, 23,000 people.

Worse case scenario again, with the current case mortality rate of 55 percent, if that pans out, heaven forbid, if you get that 55 percent mortality rate among those persons affected, we're talking about 11,000  to 12,000 dead people in a population of 47,000 people."

"That is unimaginable, but we have to do what is called scenario thinking - preparation "what if, then what."

He noted however, that in past pandemics, the mortality rates were at 10 percent. "So if ten percent of 23,000, then we're talking about 2,300 persons, which is still a large figure for a small population like ours.  So already you can imagine, the destruction, the devastation, the disruption to life as we know it, he said.

The Ministry of Health in St. Kitts  the Federal Ministry is responsible with members such as the Minister of Health, the Permanent Secretary and the Chief Medical Officer. The Chief Medical Officer's office is the point office for keeping in touch with the various agencies in both islands.

"We have what we call a National Coordinating Group on both islands and what applies to St. Kitts. applies to Nevis and vice versa.  So in both islands we have a coordinating group made up of vet services, disaster management, consumer protection, consumer affairs, community health services and hospital services," said Dr. Martin.

He said that both animal health and human health are in contact with their respective international agencies, the World Health Organization on the human side and the Organization of Animal on the animal health side.

"There are meetings internationally, regionally, locally and also meetings cutting across, the cross fertilisation between the animal health side and the human health side, the CMO disclosed.